We have long suspected that autism is not a single disorder. As our lab tests become more sophisticated that is becoming more likely. A few years ago, I wrote about a new chromosomal abnormality that was associated with autism. At that point, it brought the number of cases of autism due to a chromosomal abnormality up to 3%. Thus if children with autism have chromosome studies done, about 3% of them will have a genetic abnormality consistent with that. When I was in medical school, we could simply count the total number of chromosomes in the body. There were 46 of them. You either had 46 chromosomes or you did not. If you had 47, then you might have a disorder like Down's syndrome. If you had 45, you might have something called Turner's syndrome. However, over the years we have become much more precise. Now we can detect when an extra piece of chromosome present. We can also detect when a piece of chromosome is missing. We could not do that in the past. All we could tell if the total number was correct. For years we knew that autism rates in identical twins was much higher than in brothers and sisters. For that reason, there had to be some kind of genetic component. In most cases we figured it was a combination of something in the genes and something in the environment that set off the disorder. At a recent conference I attended, a geneticist talked about the various chromosomal problems that are found with autism. He is now able to find a chromosome problem in about 10-12% of the patients he evaluates. Much of the increase from the 3% level has to do with a new test that is able to detect more subtle changes. The name of the test is Array Comparative Genomic Hybridization (aCGH). Given the newness of it, it is not readily available yet. Insurance companies also do not always pay for it. While it is useful to be able to give parents an answer as to the cause of their child's autism, it does not make a difference in the treatment of it. These genetic changes are permanent. They are not treatable. The current level of science is such that they will not be treatable for many, many years. The result is, regardless of the cause of autism, the treatment remains that same. It involves early diagnosis. It involves early childhood education programs when the diagnosis is made. It involves speech therapy. It involves occupational therapy. It involves physical therapy. With the intense interest in autism, it is likely that more causes will be found over the next few years. Some of them will be genetic in nature. Others may find an environmental contaminant as a player. While a lot of people are on the immunization bandwagon, it is not likely that immunizations play any role. Other things like pesticides in the environment are far more likely. However, we do not have any data to support anything in particular right now. The percentage for which we make a specific diagnosis is rising. It will likely continue to do so.

Nanticoke offers diabetes education Nanticoke Memorial Hospital will hold a four-week diabetes educational program beginning Jan. 7, 2009 and continuing on Jan. 14, 21 and 28 from 5 to 7 p.m. at the hospital. Registration is required. Insurance may reimburse the cost of the program. This four-week program includes weekly education sessions and individualized meal planning for diabetes self-management. Our goal is to give you the self-management skills to control your diabetes. Family members are welcome to attend the weekly sessions. For more information and to register, contact Nanticoke Memorial Hospital's Diabetes Education department at 302-629-6611, ext. 2446.

Flu shots still available It's not too late to get a flu shot. Influenza is a serious disease that affects many people, including the elderly and those with serious, long-term health problems. Nanticoke Memorial Hospital's Occupational Health will be offering flu shots to the public at Nanticoke Mears Health Campus (across from Seaford Post Office) through March 2009. The cost is $20. Medicare billing is available with proof of Medicare insurance. Pre-registration is required. Large outbreaks of influenza usually do not occur before December in the USA and reach a peak between late December and early March, and many continue into the spring. The duration of protection conferred by the influenza vaccine generally begins one to two weeks after injection and may last six months or longer. Pre-registration is required. Call Nanticoke Occupational Health at 629-6875 to schedule an appointment.

LDAF Autism Ball planned The Lower Delaware Autism Foundation's Autism Ball and Auction for Hope is Saturday, March 7, 2009 at the Bay Center in Dewey Beach. The theme encourages guests to help make dreams come true for individuals with autism. The event begins with a silent auction from 6 to 8 p.m. and is followed by dinner, a live auction and dancing from 8 p.m. to midnight. There will be an open bar during the silent auction from 6 to 8 p.m. followed by a cash bar from 8 p.m. to midnight. Tickets are $125 and dress is cocktail attire. Table sponsorships are available for $2,500 and include a table for 12 guests, full page event program ad and more. Other sponsorship opportunities are also available. Entertainment will be provided by the Big City Band. Autism affects one in every 150 children born in the U.S. each year. More children will be diagnosed with autism this year than with AIDS, diabetes and cancer combined. Autism costs the nation over $90 billion annually, a figure that is expected to double in the next decade. For more information about sponsorship or volunteer opportunities, call Mary Landon Green, program and event coordinator, at 302-644-3410 or visit www.ldaf.com.

Bereavement Support Group Nanticoke Memorial Hospital is offering an eight-week Bereavement Support Group Wednesdays, beginning Jan. 7, at Nanticoke's Cancer Care Center second-floor library. The time the group meets will be based on the need of those who call to pre-register. Representatives from Delaware Hospice will provide grief education and support to individuals and families as they cope with the emotional, social, and financial stresses associated with life-limiting illness and the loss of a loved one. To pre-register for this free program contact Ms. Terri Clifton at 629-6611, ext. 2577.

Cancer Networking Support Group The Wellness Community of Delaware offers a "General Cancer Networking" support group the third Monday of each month from 4:30- 6:30 p.m. held at Nanticoke Memorial Hospital's Cancer Care Center second-floor library, Seaford. The support group is a free program of hope, understanding, and caring for people with cancer and their loved ones. Professionally led cancer support programs offer hope, education, and emotional support for adults with cancer and their loved ones who want to fight for recovery and the quality of their lives. Learn how to feel less isolated and more in control. All programs offered through The Wellness Community of Delaware are free of charge to people affected by cancer. For further information, or to register, call 645-9150.

Nanticoke Prescription Fund Nanticoke Memorial Hospital's Charity Endowment Prescription Fund is a fund that assists patients who cannot afford their medications when discharged from the hospital. In lieu of a gift to a colleague, business associate, family or friends, consider a donation to the Nanticoke Health Services Prescription Drug Fund in their name. Participants receive inserts for their holiday cards, which inform recipients that a donation has been made to the Prescription Drug Fund in their honor. Over 250 individuals from the community have already benefited from the fund, and Nanticoke Hospital wants to ensure many more will be able to benefit. Imagine a family member or friend, diagnosed with cancer, being told that it could possibly be three weeks before they receive prescription coverage for their pain and anti-nausea medications. With your donation to the Prescription Drug Fund, patients are able to receive immediate access to their medications. For further information and to participate in supporting Nanticoke's Prescription Drug Fund, contact Nanticoke's Corporate Development office at (302) 629-6611, ext. 2404. You may also contribute online at www.nanticoke.org.

Gijanto promoted to director Nanticoke Health Services has promoted Ms. Barbara Jane Gijanto BA, RN, WCC, CWOCN, to the position of Wound Care & Vascular Services director. She will oversee wound care, ostomy, and incontinence issues at Nanticoke Memorial Hospital including assisting with Nanticoke Memorial's outpatient wound care and hyperbaric center. She will also oversee outpatient patients who are experiencing difficulties managing their ostomy care and will be responsible for staff education in wound and ostomy care. Gijanto is a registered nurse, is wound care certified and is a certified wound ostomy continence nurse. She holds a bachelor's degree in psychology and is working on her master's degree in healthcare administration at Bellevue University.

Landgraf selected to serve Gov.-elect Jack Markell will nominate Rita Landgraf to be his administration's secretary of Health and Social Services. Landgraf will take over an agency that includes the Division of Public Health and state-run health care facilities, and is responsible for the administration of Medicaid, Medicare Part D and other social services to more than 100,000 Delawareans. Landgraf will bring a long history of working with Delawareans who receive state services. In addition to serving as the head of the 172,000-member AARP of Delaware organization, Landgraf is also the co-chair of the Governor's Commission on Community-Based Alternatives for Person with Disabilities. She has also served as the co-chair of the Governor's Task Force for Continued Improvement at the Delaware Psychiatric Center, director of The Arc of Delaware and director of the National Alliance for the Mentally Ill in Delaware. Landgraf began her work with the Delawareans with disabilities in 1980, after graduating from the University of Delaware, as a client assistant at United Cerebral Palsy, which advocates for Delawareans with disabilities to secure gainful employment opportunities.

Nanticoke expands testing hours Beginning Feb. 7, Nanticoke Memorial Hospital will expand Outpatient Laboratory and Radiology services testing hours to include Saturdays from 7 a.m. to 3 p.m. Patients will continue to register in the hospital lobby registration area before testing. Monday through Friday hours will remain from 7 a.m. to 7 p.m. Mears Campus hours will also remain unchanged, Monday through Friday from 7 a.m. to 4:30 p.m.